Exhibit_G_-_Monthly_CCSD_Community_Action_Inquire_Tracking_Sheet.xlsx

XLSX spreadsheet 18 KB Posted

Attached to
Master Agreement AZ|CTR075477
Contract number
CTR075477
Issued by
Arizona

About this file

The document is an Exhibit G form from the Arizona Department of Economic Security (DES), specifically a Community Action Inquiry Tracking Sheet designed to monitor and record community service inquiries and requests. The form appears to be an administrative tracking mechanism for documenting service interactions across different communication channels including in-person, phone, email, and agency portal.

The tracking sheet is structured to capture details about service requests in categories such as housing, utility assistance, case management, and other supplemental services like food boxes or gas cards. The document provides a systematic method for recording inquiry types, outcomes (including denials and withdrawals), and the various channels through which community members seek assistance. While the specific monetary values are not detailed in this document, it serves as a critical administrative tool for monitoring and reporting community action service interactions for the Arizona DES CCSD (likely Child and Community Services Division) program.

View the file

Other files

Show all 18

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

SERVICES REQUESTED SHEET

Exhibit G
Arizona Department of Economic Security
CCSD COMMUNITY ACTION INQUIRY TRACKING SHEET
DATEIN PERSONPHONEEMAILHOUSINGUTILITYCASE MGMENTOTHERDeniedWithdrawn

DCAD COMMUNITY ACTION INQUIRY TRACKING SHEET

SERVICES REQUESTED SHEET (rev.

Exhibit G
Arizona Department of Economic Security

CCSD COMMUNITY ACTION INQUIRY TRACKING SHEET

Instructions: List the number of households inquiries.

Agency Name:
Month/Year:
INQUIRYTYPEOUTCOME
IN PERSONPHONEEMAILAGENCY PORTALHOUSINGUTILITYCASE MANAGEMENTOTHER
(i.e., food boxes, gas card, etc.)DENIALWITHDRAWN

DCAD COMMUNITY ACTION INQUIRY TRACKING SHEET

File details come from the government source that posted it. Updated .